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Nonprofiteer
← COMMUNITY PHYSICIANS ASSOCIATES INC

Form 990 for tax year 2022

Filed by COMMUNITY PHYSICIANS ASSOCIATES INC.

Totals

Total revenue
$4,762,741
Total expenses
$7,272,362
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$4,714,765
Investment income
$0
Other revenue
$47,976
Total assets, end of year
$1,481,050
Total liabilities, end of year
$4,505,320
Net assets or fund balances, end of year
-$3,024,270
Program services expenses (Part IX)
$7,243,961
Management and general expenses
$28,401
Fundraising expenses
$0
Program service expenses (Part III)
$7,243,961

Program services were 99.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • ROWAN MICHAEL

    TRUSTEE (EX-OFFICIO) (CEO DESIGNEE)

    Total calculated
    $1,335,874
    From this org
    $0
    From related orgs
    $1,298,835
    Other
    $37,039
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,190,783 related
    Bonus
    $0
    Other
    $0 + $108,052 related
    Deferred
    $0 + $9,371 related
    Nontaxable benefits
    $0 + $27,668 related
    Filer's total
    $0 + $1,335,874 related
  • BERRY MD MICHAEL

    TRUSTEE

    Total calculated
    $995,673
    From this org
    $974,763
    From related orgs
    $0
    Other
    $20,910
    Hours/week
    55 + 2 related

    Schedule J breakdown matched by us

    Base
    $934,821
    Bonus
    $1,000
    Other
    $38,942
    Deferred
    $0
    Nontaxable benefits
    $20,910
    Filer's total
    $995,673
  • SIAO MD DANIEL CHI CHANG

    TTEE (EX-OFF) (PRES, MEDICAL STAFF)

    Total calculated
    $509,456
    From this org
    $0
    From related orgs
    $435,510
    Other
    $73,946
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $426,283 related
    Bonus
    $0 + $4,562 related
    Other
    $0 + $4,665 related
    Deferred
    $0 + $30,500 related
    Nontaxable benefits
    $0 + $43,446 related
    Filer's total
    $0 + $509,456 related
  • FERNANDEZ RICHARD

    PRESIDENT & TRUSTEE (EX-OFFICIO)

    Total calculated
    $499,617
    From this org
    $0
    From related orgs
    $461,277
    Other
    $38,340
    Hours/week
    1 + 58 related

    Schedule J breakdown matched by us

    Base
    $0 + $453,480 related
    Bonus
    $0
    Other
    $0 + $7,797 related
    Deferred
    $0 + $7,320 related
    Nontaxable benefits
    $0 + $31,020 related
    Filer's total
    $0 + $499,617 related
  • O'CONNOR MD HEIDI

    TRUSTEE

    Total calculated
    $413,437
    From this org
    $0
    From related orgs
    $361,598
    Other
    $51,839
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $274,051 related
    Bonus
    $0 + $65,564 related
    Other
    $0 + $21,983 related
    Deferred
    $0 + $30,000 related
    Nontaxable benefits
    $0 + $21,839 related
    Filer's total
    $0 + $413,437 related
  • BRESNICK MD MORGAN

    TRUSTEE

    Total calculated
    $340,290
    From this org
    $0
    From related orgs
    $274,149
    Other
    $66,141
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $270,267 related
    Bonus
    $0
    Other
    $0 + $3,882 related
    Deferred
    $0 + $28,000 related
    Nontaxable benefits
    $0 + $38,141 related
    Filer's total
    $0 + $340,290 related
  • RANGAVIZ SHEILAH

    CFO AND ASSISTANT TREASURER

    Total calculated
    $295,404
    From this org
    $0
    From related orgs
    $284,164
    Other
    $11,240
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $256,231 related
    Bonus
    $0 + $20,964 related
    Other
    $0 + $6,969 related
    Deferred
    $0 + $3,046 related
    Nontaxable benefits
    $0 + $8,194 related
    Filer's total
    $0 + $295,404 related
  • CICHELLO ANTHONY

    TRUSTEE, CHAIR

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • LAURENCE ANDREW

    TRUSTEE & VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • ALEXOPOULOS ALEXANDRA

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • BURKE JOHN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • COLLINS HARRIS E

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • CORNFORTH STACEY

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • DENNY STEPHEN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • GAFFNEY THERESA

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • MARR JEFFREY

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • OKARA EBI

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • O'NEIL ALISA

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • PATHAK RAJU

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • RICE BRIDGET

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • SHIH DIN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • SULLIVAN JOSEPH C

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • TABB MD KEVIN

    CHIEF EXECUTIVE OFFICER

    Total calculated
    $2,807,152
    From this org
    $0
    From related orgs
    $2,507,235
    Other
    $299,917
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $2,103,982 related
    Bonus
    $0
    Other
    $0 + $403,253 related
    Deferred
    $0 + $257,320 related
    Nontaxable benefits
    $0 + $42,597 related
    Filer's total
    $0 + $2,807,152 related
  • KERNDL JOHN

    TREAS (EXECUTIVE VP & CFO, BILH)

    Total calculated
    $1,335,872
    From this org
    $0
    From related orgs
    $1,301,463
    Other
    $34,409
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,068,846 related
    Bonus
    $0 + $100,000 related
    Other
    $0 + $132,617 related
    Deferred
    $0 + $4,985 related
    Nontaxable benefits
    $0 + $29,424 related
    Filer's total
    $0 + $1,335,872 related
  • RIOS CINDY

    TREAS (EX-OFF) (INTERIM CFO, BILH)

    Total calculated
    $1,022,982
    From this org
    $0
    From related orgs
    $802,046
    Other
    $220,936
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $574,544 related
    Bonus
    $0 + $174,475 related
    Other
    $0 + $53,027 related
    Deferred
    $0 + $188,510 related
    Nontaxable benefits
    $0 + $32,426 related
    Filer's total
    $0 + $1,022,982 related
  • KATZ ESQ JAMIE

    CLERK

    Total calculated
    $914,057
    From this org
    $0
    From related orgs
    $898,193
    Other
    $15,864
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $794,826 related
    Bonus
    $0
    Other
    $0 + $103,367 related
    Deferred
    $0 + $7,320 related
    Nontaxable benefits
    $0 + $8,544 related
    Filer's total
    $0 + $914,057 related
  • GEE ESQ CARROLL

    ASST CLERK (EX-OFF), ASST GC, BILH

    Total calculated
    $188,870
    From this org
    $0
    From related orgs
    $160,056
    Other
    $28,814
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $159,422 related
    Bonus
    $0 + $500 related
    Other
    $0 + $134 related
    Deferred
    $0 + $1,347 related
    Nontaxable benefits
    $0 + $27,467 related
    Filer's total
    $0 + $188,870 related
  • DESOCIO MICHAEL

    CFO, BILH PRIMARY CARE NETWORK

    Total calculated
    $405,678
    From this org
    $0
    From related orgs
    $343,973
    Other
    $61,705
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $291,301 related
    Bonus
    $0 + $34,470 related
    Other
    $0 + $18,202 related
    Deferred
    $0 + $36,000 related
    Nontaxable benefits
    $0 + $25,705 related
    Filer's total
    $0 + $405,678 related
  • FENTON ANGELA

    VP AMBULATORY AND CLINICAL SERVICES

    Total calculated
    $223,736
    From this org
    $0
    From related orgs
    $191,675
    Other
    $32,061
    Hours/week
    1 + 56 related

    Schedule J breakdown matched by us

    Base
    $0 + $191,474 related
    Bonus
    $0 + $100 related
    Other
    $0 + $101 related
    Deferred
    $0 + $5,062 related
    Nontaxable benefits
    $0 + $26,999 related
    Filer's total
    $0 + $223,736 related
  • BURKE DENNIS

    ORTHOPEDIC SURGEON

    Total calculated
    $885,005
    From this org
    $858,443
    From related orgs
    $0
    Other
    $26,562
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $856,195
    Bonus
    $0
    Other
    $2,248
    Deferred
    $0
    Nontaxable benefits
    $26,562
    Filer's total
    $885,005
  • SHERVIN NINA

    PHYSICIAN, ORTHOPEDICS

    Total calculated
    $705,784
    From this org
    $696,017
    From related orgs
    $0
    Other
    $9,767
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $668,460
    Bonus
    $1,000
    Other
    $26,557
    Deferred
    $0
    Nontaxable benefits
    $9,767
    Filer's total
    $705,784
  • KELLY CARMEL

    PHYSICIAN, GERIATRIC MEDICINE

    Total calculated
    $196,476
    From this org
    $185,706
    From related orgs
    $0
    Other
    $10,770
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $178,344
    Bonus
    $0
    Other
    $7,362
    Deferred
    $0
    Nontaxable benefits
    $10,770
    Filer's total
    $196,476
  • MACROPOULOS JOHN

    PHYSICIAN ASSISTANT

    Total calculated
    $195,978
    From this org
    $167,201
    From related orgs
    $0
    Other
    $28,777
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $162,150
    Bonus
    $5,000
    Other
    $51
    Deferred
    $0
    Nontaxable benefits
    $28,777
    Filer's total
    $195,978
  • MERITHEW SUZZANNE

    PHYSICIAN ASSISTANT

    Total calculated
    $178,153
    From this org
    $166,987
    From related orgs
    $0
    Other
    $11,166
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $166,760
    Bonus
    $0
    Other
    $227
    Deferred
    $0
    Nontaxable benefits
    $11,166
    Filer's total
    $178,153

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Tax indemnification and gross-up payments
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

SCHEDULE J, PART I LINE 1A. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS
FROM TIME TO TIME AND UNDER CERTAIN CIRCUMSTANCES, COMMUNITY PHYSICIANS ASSOCIATES, INC. OR ONE OF IT'S AFFILIATES MAY CHOOSE TO GROSS-UP A PAYMENT TO MAKE THE EMPLOYEE WHOLE FROM A TAX PERSPECTIVE. AS EXPLAINED FURTHER BELOW, ACROSS BILH THESE SITUATIONS ARE REVIEWED ON A CASE-BY-CASE BASIS AND THE COST OF ANY GROSS-UP IS CONSIDERED WHEN REVIEWING AN EMPLOYEE'S OVERALL COMPENSATION PACKAGE FOR REASONABLENESS. EXAMPLES OF THE TYPES OF EXPENSES WHICH FALL INTO THIS CATEGORY ARE REIMBURSEMENT FOR RELOCATION AND TEMPORARY HOUSING. SCHEDULE J, PART I LINE 3. CEO/PRESIDENT/EXECUTIVE DIRECTOR COMPENSATION COMMUNITY PHYSICIANS ASSOCIATES, INC.'S CHIEF EXECUTIVE OFFICER AND PRESIDENT ARE EMPLOYED THROUGH BETH ISRAEL LAHEY HEALTH (BILH), WHICH AS NOTED THROUGHOUT THIS FILING, IS THE DIRECT OR INDIRECT SOLE MEMBER OF COMMUNITY PHYSICIANS ASSOCIATES, INC. IN THIS CAPACITY, THE BILH COMPENSATION COMMITTEE SETS COMPENSATION FOR THE CEO AND PRESIDENT OF COMMUNITY PHYSICIANS ASSOCIATES, INC. AS NOTED IN RESPONSE TO THIS FORM 990 PART VI QUESTIONS 15A AND 15B, THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIES UPON PUBLISHED COMPENSATION SURVEYS AND STUDIES PRODUCED BY INDEPENDENT COMPENSATION CONSULTING FIRMS THAT REGULARLY ASSESS EXECUTIVE COMPENSATION AND BENEFITS OF SUBSTANTIALLY SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MEETS TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWS THE COMPENSATION SURVEY DETAILS PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. FOR SOME CATEGORIES OF POSITIONS, THE COMPENSATION COMMITTEE WILL REVIEW THE COMPENSATION STRUCTURE AND TARGETS AS A GROUP, RATHER THAN BY INDIVIDUAL. COMPENSATION FOR THE BILH CEO AND OTHER SENIOR EXECUTIVES IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTES TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE BILH CEO. THE COMPENSATION PACKAGE FOR THE BILH CEO AS VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BILH BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS FOR BOTH THE COMPENSATION COMMITTEE AND THE BOARD OF TRUSTEES ARE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION COMMITTEE PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION. SCHEDULE J PART I LINE 4B NON-QUALIFIED PLANS BILH AND ITS AFFILIATES MAINTAIN CERTAIN SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. DURING THE PERIOD COVERED BY THIS FILING, ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, MAY HAVE PARTICIPATED IN ONE OR MORE OF THE FOLLOWING PLANS, WHICH UNDER THE DEFINITION TO THIS FORM 990 ARE SUPPLEMENTAL NONQUALIFIED PLANS: BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM, BETH ISRAEL LAHEY HEALTH, INC. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, LAHEY CLINIC FOUNDATION, INC. 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN PHYSICIANS, SENIOR MANAGEMENT AND DEFINED MEDICAL STAFF, THE JORDAN HEALTH SYSTEMS, INC. 457(F) DEFERRED COMPENSATION PLAN. IN ADDITION, DURING THE PERIOD COVERED BY THIS FILING, ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, MAY HAVE PARTICIPATED IN ONE OR MORE OF THESE ADDITIONAL IRC 457(B) PLANS AND BENEFITS FROM PARTICIPATING IN ONE OF THESE PLANS IS ALSO REPORTED IN THIS FORM 990: ANNA JAQUES HOSPITAL SELECT GROUP 457(B) DEFERRED COMPENSATION PLAN, BETH ISRAEL DEACONESS HOSPITAL MILTON 457(B) PLAN, BETH ISRAEL DEACONESS MEDICAL CENTER 457(B) PLAN, BETH ISRAEL LAHEY HEALTH, INC. 457(B) DEFERRED COMPENSATION PLAN, LAHEY CLINIC FOUNDATION, INC. 457(B) NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN PHYSICIANS, SENIOR MANAGEMENT AND DEFINED MEDICAL STAFF, MOUNT AUBURN HOSPITAL 457(B) DEFERRED COMPENSATION PLAN, NEW ENGLAND BAPTIST HOSPITAL 457(B) PLAN, THE JORDAN HEALTH SYSTEMS, INC. ELIGIBLE DEFERRED COMPENSATION PLAN, WINCHESTER HOSPITAL SELECT GROUP 457(B) DEFERRED COMPENSATION PLAN, EXETER HEALTH RESOURCES, INC. 457(B) RETIREMENT SAVINGS PLAN, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. 457(B) DEFERRED COMPENSATION PLAN. THESE PLANS ARE NON-QUALIFIED DEFERRED COMPENSATION PLANS AND PURSUANT TO THE PLANS, ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS. AMOUNTS RECEIVED BY PARTICIPANTS, DEFERRED BY PARTICIPANTS AND THE CHANGE IN VALUE OF THE PLAN BENEFITS RELATED TO THESE PARTICIPANTS'' ACCOUNTS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW.
SCHEDULE J PART I LINE 7 NON-FIXED PAYMENTS
AS NOTED ABOVE, THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES. DURING THE 2022 CALENDAR YEAR, BILH MAINTAINED EXECUTIVE COMPENSATION PACKAGES WHICH INCLUDED OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF VARIOUS FACTORS, INCLUDING BUT NOT LIMITED TO, MEETING OR EXCEEDING THE EMPLOYING ENTITY'S OBJECTIVES FOR QUALITY AND PATIENT SAFETY, BUDGETED CONSOLIDATED OPERATING MARGIN, AND MEETING INDIVIDUAL GOALS AND OBJECTIVES. IN EACH CASE, INCENTIVE COMPENSATION WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE, AND FOR THE BILH CEO AS NOTED ABOVE, THE FULL BILH BOARD OF TRUSTEES. ADDITIONAL INFORMATION IS INCLUDED IN THE EXPLANATORY NOTES TO THIS SCHEDULE J.
ADDITIONAL EXPLANATORY NOTES:
DIRECTORS AND TRUSTEES SERVE WITHOUT COMPENSATION: ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS/TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES IN THE NOTES BELOW. REPORTING PERIOD: AS REQUIRED BY FORM 990, COMPENSATION REPORTED IN THE FILING FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 IS CALENDAR YEAR 2022 COMPENSATION. COMPENSATION SOURCES: COMPENSATION REPORTED FOR INDIVIDUALS MAY INCLUDE COMPENSATION PAID BY THE REPORTING ENTITY, AN AFFILIATE OF THE REPORTING ENTITY AND IN SOME CASES UNRELATED ENTITIES AS REQUIRED BY FORM 990. REPORTABLE COMPENSATION: REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION: OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. BASE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN BASE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: ORDINARY WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN OTHER REPORTABLE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN OTHER REPORTABLE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER SUBSIDIZED PARKING; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE. DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401(K) RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403(B) RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE, AMONG OTHER THINGS, AMOUNTS FROM ONE OR MORE OF THE FOLLOWING NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, ADOPTION ASSISTANCE, TUITION ASSISTANCE PURSUANT TO AN EMPLOYER PLAN, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ADDITIONAL INDIVIDUAL SPECIFIC INFORMATION IS INCLUDED BELOW. BERRY, M.D., MICHAEL TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TRUSTEE - BETH ISRAEL DEACONESS MILTON PHYSICIAN ASSOCIATES, INC. TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. BRESNICK, M.D., MORGAN TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TRUSTEE - BETH ISRAEL DEACONESS MILTON PHYSICIAN ASSOCIATES, INC. TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. BURKE, DENNIS ORTHOPEDIC SURGEON - COMMUNITY PHYSICIANS ASSOCIATES, INC. DESOCIO, MICHAEL UNLESS OTHERWISE NOTED BELOW, MR. DESOCIO HELD THE FOLLOWING POSITIONS THROUGH HIS RETIREMENT ON MARCH 15, 2023: CHIEF FINANCIAL OFFICER, BETH ISRAEL HEALTH PRIMARY CARE NETWORK CHIEF FINANCIAL OFFICER MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP TERM ENDED ON FEBRUARY 6, 2023 CHIEF FINANCIAL OFFICER, BETH ISRAEL HEALTH PRIMARY CARE, INC. CHIEF FINANCIAL OFFICER, BETH ISRAEL LAHEY HEALTH PRIMARY CARE NETWORK- COMMUNITY PHYSICIANS ASSOCIATES, INC. CHIEF FINANCIAL OFFICER, BETH ISRAEL LAHEY HEALTH PRIMARY CARE NETWORK - SEACOAST AFFILIATED GROUP PRACTICE, INC. CHIEF FINANCIAL OFFICER, BETH ISRAEL LAHEY HEALTH PRIMARY CARE NETWORK - NORTHEAST MEDICAL PRACTICE, INC. AS NOTED ABOVE, MR. DESOCIO SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. FENTON, ANGELA VICE PRESIDENT OF AMBULATORY AND CLINIC SERVICES BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. VICE PRESIDENT OF AMBULATORY AND CLINICAL SERVICES - BETH ISRAEL DEACONESS MILTON PHYSICIANS ASSOCIATES, INC. VICE PRESIDENT OF AMBULATORY AND CLINICAL SERVICES - COMMUNITY PHYSICIANS ASSOCIATES, INC. FERNANDEZ, RICHARD PRESIDENT AND TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. PRESIDENT AND TRUSTEE (EX-OFFICIO) COMMUNITY PHYSICIANS ASSOCIATES, INC. PRESIDENT AND TRUSTEE (EX-OFFICIO) BID-MILTON PHYSICIANS ASSOCIATES, INC. TRUSTEE BETH ISRAEL LAHEY HEALTH PHARMACY, INC. MR. FERNANDEZ SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. FERNANDEZ INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $5,407. THIS AMOUNT INCLUDES A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $23,540 AND UNREALIZED LOSSES IMPACTING HIS NONQUALIFIED BENEFIT IN THE AMOUNT OF $37,633 WHICH IS UNVESTED.
ADDITIONAL EXPLANATORY NOTES: (CONTINUED)
GEE, ESQ, CARROLL ASSISTANT CLERK (EX-OFFICIO), ASSISTANT GENERAL COUNSEL, BILH - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. ASSISTANT CLERK (EX-OFFICIO), ASSISTANT GENERAL COUNSEL, BILH - BETH ISRAEL DEACONESS MILTON PHYSICIANS ASSOCIATES, INC. ASSISTANT CLERK (EX-OFFICIO), ASSISTANT GENERAL COUNSEL - BILH - COMMUNITY PHYSICIANS ASSOCIATES, INC. KATZ, ESQ., JAMIE UNLESS OTHERWISE NOTED BELOW, MR. KATZ HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2023: GENERAL COUNSEL AND CLERK (EX-OFFICIO), - BETH ISRAEL LAHEY HEALTH, INC. CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. CLERK (EX-OFFICIO) - MOUNT AUBURN HOSPITAL CLERK (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. CLERK - COMMUNITY PHYSICIANS ASSOCIATES, INC. CLERK (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. CLERK (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. CLERK (EX-OFFICIO) - THE JORDAN HEALTH SYSTEMS, INC. CLERK (EX-OFFICIO) - ANNA JAQUES HOSPITAL CLERK - SEACOAST AFFILIATED GROUP PRACTICE, INC. TRUSTEE AND CLERK (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TRUSTEE (EX-OFFICIO)RAND CLERK (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND CLERK (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. DIRECTOR AND CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. CLERK (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. CLERK (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. CLERK (EX-OFFICIO) - LAHEY CLINIC, INC. CLERK (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC.D/B/A LAHEY HOSPITAL & MEDICAL CENTER CLERK (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. TRUSTEE AND CLERK - CAB HEALTH AND RECOVERY SERVICES, INC. TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL CLERK (EX-OFFICIO) - JOSLIN CLINIC, INC. CLERK (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. CLERK (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. CLERK - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP TERM BEGAN ON MARCH 31, 2023 CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. TERM BEGAN ON MARCH 31, 2023 EFFECTIVE JULY 1, 2023, BETH ISRAEL LAHEY HEALTH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES INC. WHICH IN TURN SERVES AS THE SOLE MEMBER OF EXETER HOSPITAL AND ADDITIONAL AFFILIATES. AS OF THAT DATE MR. KATZ ASSUMED THE FOLLOWING ADDITIONAL POSITIONS: CLERK (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. CLERK (EX-OFFICIO) - EXETER HOSPITAL, INC. CLERK (EX-OFFICIO) - CORE PHYSICIANS, LLC SECRETARY (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. KATZ INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $68,094. INCLUDED IN THIS AMOUNT IS A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $72,875 AND AN UNREALIZED LOSS IN THE AMOUNT OF $24,281. KELLY, CARMEL PHYSICIAN, GERIATRIC MEDICINE - COMMUNITY PHYSICIANS ASSOCIATES, INC. KERNDL, JOHN UNLESS OTHERWISE NOTED BELOW, MR. KERNDL HELD THE FOLLOWING POSITIONS THROUGH DECEMBER 31, 2022: EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. TRUSTEE AND TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. TREASURER - COMMUNITY PHYSICIANS ASSOCIATES, INC. TREASURER - CAREGROUP PARMENTER HOME CARE & HOSPICE, INC. TRUSTEE, TREASURER (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. TREASURER (EX-OFFICIO) - THE JORDAN HEALTH SYSTEMS, INC. TREASURER (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER TRUSTEE AND TREASURER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL TREASURER (EX-OFFICIO) MOUNT AUBURN PROFESSIONAL SERVICES ASSISTANT TREASURER (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP TREASURER (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. TREASURER (EX-OFFICIO) - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO), TREASURER(EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. TRUSTEE (EX-OFFICIO), TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TREASURER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. TRUSTEE AND TREASURER (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. TREASURER (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL DIRECTOR (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. TRUSTEE (EX-OFFICIO), TREASURER (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. MANAGING DIRECTOR - BETH ISRAEL DEACONESS PHYSICIAN ORGANIZATION, LLC MANAGING DIRECTOR, TREASURER - BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK, LLC TREASURER (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE ACCOUNTABLE CARE ORGANIZATION, LLC TREASURER (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE NETWORK, LLC ASSISTANT TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. TREASURER (EX-OFFICIO) - JOSLIN CLINIC, INC. TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. KERNDL INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $109,434. OF THIS AMOUNT, $89,934 WAS UNVESTED AT SEPTEMBER 30, 2023. OTHER REPORTABLE COMPENSATION FOR MR. KERNDL ALSO INCLUDES $ 7,961 RELATED TO TEMPORARY HOUSING.
ADDITIONAL EXPLANATORY NOTES: (CONTINUED)
MACROPOULOS, JOHN PHYSICIAN ASSISTANT- COMMUNITY PHYSICIANS ASSOCIATES, INC. MERITHEW, SUZZANNE PHYSICIAN ASSISTANT - COMMUNITY PHYSICIANS ASSOCIATES, INC. O'CONNOR, M.D., HEIDI TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TRUSTEE - BETH ISRAEL DEACONESS MILTON PHYSICIAN ASSOCIATES, INC. TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. O'CONNOR INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $17,462. INCLUDED IN THIS AMOUNT IS AN UNREALIZED LOSS IN THE AMOUNT OF $2,538 IMPACTING THE NONQUALIFIED UNVESTED BALANCE. RANGAVIZ, SHEILAH CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER COMMUNITY PHYSICIANS ASSOCIATES, INC. CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER (EX-OFFICIO) - BID-MILTON PHYSICIAN ASSOCIATES, INC. MS. RANGAVIZ SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. INCENTIVE COMPENSATION FOR MS. RANGAVIZ INCLUDES A MILESTONE PAYMENT IN THE AMOUNT OF INCLUDES A PAYMENT IN THE AMOUNT OF $20,964. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS. RANGAVIZ INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $6,735. RIOS, CINDY TREASURER (EX-OFFICIO) AND INTERIM CHIEF FINANCIAL OFFICER BETH ISRAEL LAHEY HEALTH, INC. TERM BEGAN JANUARY 1, 2023. SENIOR VICE PRESIDENT AND OPERATIONS CHIEF FINANCIAL OFFICER BETH ISRAEL LAHEY HEALTH, INC. TERM ENDED DECEMBER 31, 2022 UNLESS OTHERWISE NOTED, EFFECTIVE JANUARY 1, 2023, MS. RIOS ALSO ASSUMED THE FOLLOWING POSITIONS: TREASURER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP TERM BEGAN MARCH 31, 2023 TREASURER (EX-OFFICIO) - CAREGROUP PARMENTER HOME CARE & HOSPICE, INC. TREASURER (EX-OFFICIO) - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. TRUSTEE & TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TREASURER (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. TERM BEGAN MARCH 31, 2023 TREASURER (EX-OFFICIO) - COMMUNITY PHYSICIANS ASSOCIATES, INC. TREASURER (EX-OFFICIO) - JOSLIN CLINIC, INC. TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. TREASURER (EX-OFFICIO) - THE JORDAN HEALTH SYSTEMS, INC. TREASURER (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER TREASURER (EX-OFFICIO) - LAHEY CLINIC, INC. TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL TREASURER (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TREASURER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. DIRECTOR & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. TREASURER (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE & TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. TRUSTEE & TREASURER (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. TRUSTEE & TREASURER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE, INC. TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE & TREASURER (EX-OFFICIO) - SEACOAST NURSING & REHABILITATION CENTER, INC. TRUSTEE & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL EFFECTIVE JULY 1, 2023, BETH ISRAEL LAHEY HEALTH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES INC. WHICH IN TURN SERVES AS THE SOLE MEMBER OF EXETER HOSPITAL AND ADDITIONAL AFFILIATES. AS OF THAT DATE MS. RIOS ASSUMED THE FOLLOWING ADDITIONAL POSITIONS: TREASURER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. TREASURER (EX-OFFICIO) - EXETER HOSPITAL, INC. TREASURER (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOC & HOSPICE MS. RIOS SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR TEMPORARY HOUSING AND MOVING EXPENSES IN THE AMOUNT OF $41,927 AND 9,904, RESPECTIVELY. DEFERRED COMPENSATION IN THE AMOUNT OF $187,500 INCLUDED IN THIS FILING FOR MS. RIOS RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2022, WAS NOT FUNDED, WAS NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990.
ADDITIONAL EXPLANATORY NOTES: (CONTINUED)
ROWAN, MICHAEL UNLESS OTHERWISE NOTED BELOW, MR. ROWAN HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2023: EXECUTIVE VICE PRESIDENT, HOSPITAL AND AMBULATORY SERVICES - BETH ISRAEL LAHEY HEALTH, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. TRUSTEE (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - COMMUNITY PHYSICIANS ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - THE JORDAN HEALTH SYSTEMS, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BID - MILTON PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - JOSLIN CLINIC, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - JOSLIN DIABETES CENTER, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - ANNA JAQUES HOSPITAL, INC. TERM BEGAN ON APRIL 1, 2023. TRUSTEE (CEO DESIGNEE) - SEACOAST AFFILIATED GROUP PRACTICE, INC. TERM BEGAN ON APRIL 1, 2023. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - WINCHESTER HOSPITAL TERM BEGAN ON MARCH 10, 2023. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - WINCHESTER HEALTHCARE MANAGEMENT, INC. TERM BEGAN ON MARCH 10, 2023. MR. ROWAN SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. ROWAN INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $84,688. OF THIS AMOUNT, $65,188 IS UNVESTED AS OF SEPTEMBER 30, 2023. SHERVIN, NINA PHYSICIAN, ORTHOPEDICS - COMMUNITY PHYSICIANS ASSOCIATES, INC. SIAO, M.D., DANIEL CHI CHANG TRUSTEE (EX-OFFICIO) AND PRESIDENT, MEDICAL STAFF BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. CHIEF MEDICAL OFFICER BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TERM STARTED AUGUST 1, 2023 TRUSTEE BETH ISRAEL DEACONESS MILTON PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) AND PRESIDENT, MEDICAL STAFF COMMUNITY PHYSICIANS ASSOCIATES, INC. TABB, M.D., KEVIN UNLESS OTHERWISE NOTED BELOW, DR. TABB HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2023: PRESIDENT AND CHIEF EXECUTIVE OFFICER; TRUSTEE (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. CHIEF EXECUTIVE OFFICER AND TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC, INC. TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. PRESIDENT (EX-OFFICIO) AND TRUSTEE (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE, BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HOSPITAL DIRECTOR AND PRESIDENT (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION CHIEF EXECUTIVE OFFICER (EX-OFFICIO) AND TRUSTEE (EX-OFFICIO) NORTHEAST BEHAVIORAL HEALTH CORPORATION CHIEF EXECUTIVE OFFICER AND TRUSTEE - CAB HEALTH AND RECOVERY SERVICES, INC. CHIEF EXECUTIVE OFFICER AND TRUSTEE - HEALTH AND EDUCATION HOUSING SERVICES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. CHIEF EXECUTIVE OFFICER - COMMUNITY PHYSICIANS ASSOCIATES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL CHIEF EXECUTIVE OFFICER - THE JORDAN HEALTH SYSTEMS, INC. CHIEF EXECUTIVE OFFICER - JORDAN PHYSICIAN ASSOCIATES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN CLINIC, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. EFFECTIVE JULY 1, 2023, BETH ISRAEL LAHEY HEALTH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES INC. WHICH IN TURN SERVES AS THE SOLE MEMBER OF EXETER HOSPITAL AND ADDITIONAL AFFILIATES. AS OF THAT DATE DR. TABB ASSUMED THE FOLLOWING ADDITIONAL POSITIONS: CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - EXETER HOSPITAL, INC. IN ADDITION TO THE POSITIONS NOTED ABOVE, DR. TABB HELD THE FOLLOWING POSITIONS FOR WHICH HE WAS ENTITLED TO AND DID APPOINT A DESIGNATE WHO THEN BECAME THE VOTING TRUSTEE IN HIS PLACE: TRUSTEE (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, BID-MILTON PHYSICIAN ASSOCIATES AND COMMUNITY PHYSICIANS ASSOCIATES TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, THE JORDAN HEALTH SYSTEMS, INC AND JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH PHARMACY, INC. TRUSTEE (EX-OFFICIO) MOUNT AUBURN HOSPITAL TRUSTEE (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL AND WINCHESTER HEALTHCARE MANAGEMENT TRUSTEE (EX-OFFICIO) ANNA JAQUES HOSPITAL, INC. AND SEACOAST AFFILIATED GROUP PRACTICE TRUSTEE (EX-OFFICIO) JOSLIN DIABETES CENTER TRUSTEE (EX-OFFICIO) JOSLIN CLINIC TRUSTEE (EX-OFFICIO) EXETER HEALTH RESOURCES, INC. TRUSTEE (EX-OFFICIO) EXETER HOSPITAL, INC. ALTHOUGH DR. TABB SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $388,031. THIS AMOUNT INCLUDES A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $453,944 AND UNREALIZED LOSSES IMPACTING HIS NONQUALIFIED BENEFIT IN THE AMOUNT OF $85,413. DEFERRED COMPENSATION IN THE AMOUNT OF $250,000 INCLUDED IN THIS FILING FOR DR. TABB RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2022, WAS NOT FUNDED, WAS NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2022
Filed
12 August 2024
IRS schema version
2022v5.0
Source object
202402279349301140

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